From Research to Practice - Page 7
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Most studies show that the impact of these therapies on couples can be limited. When the treatment is successful, couples frequently don't reach a level of genuine marital well-being characteristic of genuinely happy unions, even though they're less dissatisfied, and their marriages work somewhat better. Then treatment isn't always successful, so the relationships of a significant percentage of couples in most studies simply don't improve at all. It appears that with enough bad feeling and erosion of John Gottman's "positive sentiment override," couples have a hard time making real progress in therapy. In addition, even when couples experience a positive outcome, the effects may not last. The few studies that have conducted follow-ups of clients over several years frequently find regression in levels of marital satisfaction over time. This has been the case particularly with Behavioral Couples Therapy, the approach with the most follow-up studies. These findings suggest that long-term marital distress has many of the properties of a chronic condition, and may be similarly resistant to treatment.

Yet some approaches show promise of generating positive outcomes that do last. The study by Snyder and Wills of Insight-Oriented Marital Therapy showed remarkable stability in the positive effects over a five-year period. This suggests that spouses who develop insight into their problems may have better results over the long haul.

Others approaches appear to be effective even with couples who have a long history of unhappiness in their marriages. The study of Integrative Behavioral Couple Therapy by Christensen, Jacobson, and colleagues showed a clinically significant impact on an extremely distressed sample of couples. Couples included in this study displayed a high degree of marital distress in a three-step screening process and had experienced marital discord for many years. Surprisingly, 71 percent of these couples improved following treatment, moving into the range of couples in nondistressed marriages on the Dyadic Adjustment Scale, the most widely used measure of marital satisfaction.

Despite these findings of effectiveness, surveys sometimes have shown a low regard for couples therapy. In a 1995 survey conducted by Martin Seligman, Consumer Reports asked readers who'd undergone therapy, either individual or marital, for their opinion of its impact on their lives. The results demonstrated that individual psychotherapy clients were almost universally satisfied, while clients of marital counselors had the highest rates of dissatisfaction--approaching 50 percent of the sample.